Менеджмент болю при множинних переломах ребер: огляд
DOI:
https://doi.org/10.31636/prmd.v6i2.5Ключові слова:
переломи ребер, знеболення при переломах ребер, регіонарна аналгезія переломів ребер, мультимодальна аналгезія, параспінальний фасціальний блок м’яза розгинача спиниАнотація
Травми є основною причиною смертності людей молодше 40 років і займають третє місце після серцево-судинних та онкологічних захворювань. Травма грудної клітки виявляється у до 60 % пацієнтів із множинною травмою та має рівень смертності до 20–25 %. Переломи ребер є найпоширенішими у пацієнтів із торакальною травмою з рівнем смертності серед госпіталізованих пацієнтів від 10 до 22 %. Рівень смертності вищий у пацієнтів похилого віку та пацієнтів із флотуючою грудною кліткою. Захворюваність на пневмонію у людей похилого віку з трьома-чотирма і більше ніж шести переломами ребер становить 31 % і 51 % відповідно. З болем через переломи ребер складно впоратися, але ефективна аналгезія зменшує гіповентиляцію, сприяє глибокому диханню, достатньому кашлю, виведенню секрету та кращому дотриманню фізіотерапії грудної клітки. Тому якісне знеболювання не тільки підвищує комфорт пацієнта, але й дуже важливе для запобігання ускладнень і покращення результату. Метою цього огляду є аналіз сучасної літератури щодо лікування болю у пацієнта з переломами ребер і знайдення найкращих доказових практик.
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